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Tooth wear: What is it and how to smile your way out of it
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Tooth wear: What is it and how to smile your way out of it

Brushing the teeth too hard leads to dental abrasion and formation of a V-shaped notch near the gums
tooth wear, tooth erosion, tooth attrition
Representational image | Canva

Sowmya Muthuraman (31), a tutor from Erode, Tamil Nadu, experienced teeth sensitivity on the left side of her mouth to such an extent that even eating was a task. After an oral examination, her dentist told her that the sensitivity was due to vigorous brushing. She recalls that the bristles of her toothbrush used to bend outward within a month.

“My sensitivity aggravated on drinking cold water or eating ice creams and sweets,” she says. The doctor advised her to use a desensitising toothpaste and a soft-bristle toothbrush. Moreover, he taught her better brushing techniques and asked her to reduce over-vigorous brushing.

These simple techniques reduced the symptoms for Muthuraman. Though dental wear is an irreversible condition in which the enamel and dentin layers are damaged, the symptoms can be managed with proper oral hygiene. A condition that can affect all age groups, dental or tooth wear can occur in various forms including erosion, attrition, abfraction, and abrasion.

What is erosion

According to a 2018 study published by the British Dental Journal, tooth erosion is common among people in developed countries. The prevalence rate of dental erosion in children and adolescents is around 30 to 50 per cent and 20 to 45 per cent among adults.

“In tooth erosion, the mineralised portion of the tooth is lost. It is more commonly seen on the inner surface of the front teeth,” says Dr Yugashini C, a dentist from Mangaluru, Karnataka.

The causes include:

  • Unhealthy dietary habits, frequent consumption of acidic drinks and acidic fruit juices
  • Gastroesophageal reflux disease (GERD)
  • Frequent vomiting
  • Binge eating or eating disorders
  • Exposure to chlorinated water while swimming
  • Bad oral hygiene
  • Dry mouth in elders due to some medications

Erosion is not immediate but occurs after several weeks of exposure to acids.

tooth wear, tooth attrition
Representational image | Shutterstock

Attrition

Experts say that grinding of teeth happens due to stress, sleeping disorders, or anger. It damages the outer layers of the teeth and causes attrition. The process of attrition leads to a flat smooth surface of teeth with discolouration.

Also, read more about teeth grinding here.

Abfraction

Improper biting due to misalignment increases the stress on teeth and causes abfraction, says Dr Yugashini. It produces a triangular-shaped notch on the tooth’s surface. In younger individuals, alignment of teeth using orthodontic treatment (braces or clear aligners) can prevent further damage.

Abrasion

“Brushing the teeth too hard leads to dental abrasion. The other causes include using a hard bristle toothbrush, biting nails, using abrasives like toothpowders, and clasp in dentures,” says Dr Yugashini.

The constant force exerted on the teeth results in the formation of a V-shaped notch near the gums over time. The affected surface appears glossy.

The sensitivity due to abrasion commonly occurs while eating or drinking hot or cold foods or beverages. People with severe abrasion experience sensitivity even when the teeth come in contact with air. Experts say that early management of dental abrasion prevents chipping of tooth.

“When the condition is mild, or when there is little enamel loss, a desensitising toothpaste and mouthwash help to relieve sensitivity,” says Dr Yugashini.

Adopt a healthy oral routine

Since tooth wear is a progressive condition, the main goal is to prevent and reduce the risk factors.

Dr Yugashini lists out the following oral hygiene measures for healthy teeth:

  • Toothpastes containing fluoride to remineralise and strengthen the tooth enamel
  • Soft-bristle toothbrushes and proper brushing techniques after consulting a dentist
  • Adequate intake of water to increase salivary flow, thereby protecting the tooth from erosion
  • Regular dental check-ups

Reduce acidic exposure to teeth

Experts say the following steps can prevent the teeth from acidic exposure:

  • To avoid acid reflux, people with GERD should avoid spicy foods and eat at least two hours before going to bed
  • Limit the consumption of acidic beverages. Drink water after consuming acidic beverages. Using a straw when drinking acidic beverages reduces the risk of acid erosion
  • Diluting citric acid fruit juices with water can prevent enamel damage to some extent
  • Rinse the mouth after vomiting. One should avoid brushing for an hour after vomiting

How is it diagnosed?

The dentist will evaluate the diet plan and oral habits of an individual. An oral examination can tell that the enamel texture has deteriorated, and the teeth appear translucent.

According to a study published in 2015 by the Journal of Dentistry, drinking milk and eating yogurt protects the teeth from erosion. Experts say that the calcium and phosphate content in milk products remineralise teeth.

Management of teeth wear

“During the consultation, I suggest desensitising agents (a gel that is applied over the teeth) or dental varnish (a liquid that is applied over the teeth) as conservative management for individuals with minimal enamel loss. These are applied over the affected teeth to help relieve sensitivity,” says Dr Dhivya P, endodontist from Bengaluru, Karnataka.

Oral rehabilitation methods such as restoration with composite resin (a white-coloured dental cement) or veneers are used to manage the condition and for aesthetic purposes. These practices are followed if an individual has severe sensitivity and complete loss of tooth enamel, she adds.

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